National Strategy on Maternal & Infant Mortality Reduction 2009-2015 Dr. Manisone Oudom Chief of Planning and Statistic Division MCH Centre GFMER - WHO - UNFPA - LAO PDR Training Course in Reproductive Health Research Vientiane, 25 September 2009
Outline Why this strategy? How has been developed? Why develop a MNCH package? What is the content of the strategy? What are key interventions of the MNCH package? Vision, mission and goal Strategic Objectives Monitoring and evaluation
Why this strategy? To highlight key issues, priorities and actions to accelerate progress towards universal coverage of MNCH services To present a unified strategy and planning framework for the implementation of the MNCH package from 2009 to 2015 To guide stakeholders in designing, implementing and evaluating MNCH programs under strong government leadership
How has been developed? March 2007: MCH/EPI Workshop on the Strategies to Reduce MMR and IMR to Achieve MDGs 2015 : integration between MCH and EPI services is required as a core strategy to achieve MDG 4 & 5. 2008: the list of interventions is consolidated to develop an Integrated Package for MNCH and nutrition. 2008: development of document that outlines key issues and gaps to achieve MDG 1, 4 and 5, the MNCH package of interventions, and the strategies to scale up the package to reach universal coverage by 2015.
Why develop a MNCH package? To respond to the health and nutrition needs of women, newborns and children under 5 years old To accelerate progress towards the achievement of MDG 1, 4 and 5 To improve efficiency, quality and utilisation of the MNCH services
Table of contents Chapter 1. Introduction Chapter 2. Situation analysis Chapter 3. The MNCH integrated package of care and delivery mechanisms Chapter 4. Strategy overview Chapter 5. Strategy for maternal, neonatal and child mortality reduction Chapter 6. Strategy objective, key strategy, Expected results and activities Chapter 7. Monitoring and Evaluation Chapter 8. Roles and Responsibilities Chapter 9. References Chapter 10. Annexes
What are key interventions of the MNCH package? PREGNANCY Tetanus toxoid immunization Nutrition (iodine, iron, balanced energy-protein supplementation Management and prevention of maternal infections (STIs, malaria) Detection of maternal complications (eclampsia) Breastfeeding counseling Reproductive period Adolescence 10 years Pregnancy 5 years Delivery 1 year 1 week 2-4 weeks DELIVERY Basic care for every delivery (clean, safe, emergency obstetric care) Early detection and prompt management of complications, including neonatal resuscitation EARLY NEONATAL PERIOD Essential care for every newborn (drying, warming, prophylactic eye care, prevention of hypoglycemia ) Early detection and treatment of complications Special care for babies with special needs CHILDHOOD IMCI Prevention and management childhood illnesses Immunization Nutrition interventions LATE NEONATAL PERIOD Exclusive breastfeeding Appropriate hygiene Recognition of danger signs Prevention and management of illness
Strategy Vision Implementing the integrated Maternal, Neonatal and Child mortality reduction strategy will achieve universal coverage of an essential package of interventions for all mothers and children in Lao PDR regardless of gender, geographical, socioeconomic and ethnic differences
Strategy goal To reduce maternal neonatal and child mortality and maternal and child malnutrition in Lao PDR Reduce MMR to 260 per 100 000 live births Reduce child mortality to 55 per 1000 live births Reduce IMR to 45 per 1000 live births Reduce NMR to 24 per 1000 live births Reduce prevalence of malnourished U5 children by ¼ Reduce prevalence of anemia in WRA to 32%
Strategic objectives Strategic Objective 1- Improve leadership, governance and management capacity for programme implementation Strategic Objective 2- Strengthening efficiency and quality of health service provision Strategic Objective 3- Mobilising individuals, families and communities for MNCH
Nutrition Framework for the implementation of the MNCH integrated package Non- pregnancy RH care Pregnancy care Delivery care Newborn care Postnatal care Child Health care MOTHER NEWBORN CHILD DEMAND SUPPLY Leadership, Governance & Management Capacity Service Provision Individuals, Family, and Community Participation Leadership/ Governance Financing Health Information Service Delivery Health workforce Medical Products & Technology Supportive Environments Community Actions
Strategic objective 1 Improving leadership, governance and management capacity for programme implementation Strengthening leadership and governance including accountability and good governance, and policy formulation. Develop financing mechanism for increasing access to MNCH service. Improving health information or better, monitoring and evaluation of MNCH and related service.
Strategic objective 2 Strengthening efficiency and quality of health service provision Strengthening the delivery of MNCH service ( facility based service delivery, outreach, and quality improvement. Develop sufficient and skilled health worked for the provision of MNCH integrated service. Improve the management of medical products and technology for MNCH service.
Strategic objective 3 Mobilising individuals, families and communities for maternal neonatal and child health Focus on the demand side and issues such as: Empowerment of families for better MNCH Behaviour change communication strategy Community participation Roles and responsibilities of community health workers and other community resources
Monitoring and evaluation Indicators for monitoring the MNCH package Impact Outcome Process (Input & Output) MNCH scorecard for monitoring Monitoring and evaluation coordination and reporting for MNCH